First, you can choose to have a Health Maintenance Organization (HMO) plan. In an HMO plan you will be paying for all of your coverage through a monthly premium, in addition to various copayments for doctor and hospital visits. Essentially, doctors and other health care providers make an agreement with an insurance company that says they will abide by the insurance company's rules about this particular type of care in exchange for a steady stream of patients. Doctors are guaranteed a set income, insurance companies are guaranteed quality physicians, and the insurance companies’ customers are guaranteed that they will have accessible doctors when needed.
You can also choose a Preferred Provider Organization (PPO) plan (sometimes referred to as a “participating provider organization” or a “preferred provider option”). This sort of plan is subscription-based. You pay a monthly or yearly rate for access to your insurance company and its network of preferred physicians. This option tends to require pre-authorization for a lot of services, including emergencies and surgical procedures. PPOs may be more expensive than other kinds of health insurance, but they offer patients a greater deal of flexibility in choosing their care and finding doctors and facilities that are right for them. This can also sometimes be called an Exclusive Provider Organization (EPO) plan in cases where the health care provider and the insurance company mutually agree to contract only with one another. The same basic concept as a PPO applies, however.
Or you may want to choose a Point of Service (POS) plan. These are are a kind of combination between HMO and PPO plans. In a POS plan, there may be less choice for you as a customer/patient, but it will come at a lower cost. Care is handled through a primary care physician, who is within the insurance company's network. This makes a primary doctor the point of service for the insurance plan. Everything is managed through that doctor. He or she will be the one who recommends and transfers medical care through the company's network, and as long as you stay inside the network, the doctors do all the paperwork and insurance handling for you. If you choose to go outside of the network, you will have to handle all of that yourself and the insurance company will cover far less of the cost of health care.
Your other option is a Fee-for-Service plan, or Indemnity. This is the simplest sort of health insurance because it provides reimbursement to your health care providers on a case-by-case basis for particular services. It's health insurance at its most basic: you pay your premium and, after you visit a doctor, you take the paperwork with you and forward it on to the insurance company. The company will pay you a set amount back. It's very simple, and relatively cheap.
On our website, you will be able to choose between all of these options and find whichever one is right for you and your family, whether it be a question of cost, coverage or flexibility.